Timely initiation of first antenatal care visit and associated factors among pregnant women in the Amhara Region, North-west Ethiopia: a comparative cross-sectional study

INTRODUCTION: timely initiation of the first antenatal care visit is still a major public health problem in Ethiopia, especially in Amhara Region. This study assessed the prevalence of timely initiation of first ANC visit and its associated factors among pregnant women in transformed and non-transformed districts, Awi zone, Amhara Region, North-west Ethiopia. METHODS: a community-based comparative cross-sectional study was conducted from November-December 2020, among 748 women. A multistage-stratified random sampling technique was used. Data were collected by a structured questionnaire. Data analysis was done by SPSS-version 20. Binary logistics regression analysis was used to identify factors. The odds ratios were computed and a p-value < 0.05 was used to declare statistical significance. RESULTS: the overall prevalence of timely first ANC visits was 40% (95%CI: 36.6-43.7%). It was higher for the transformed districts 46.9% (95%CI: 42.1%-52.5%) compared to non-transformed districts 32.9% (95%CI: 28.3%-37.9%). Higher wealth (AOR=2.17, 95%CI: 1.44-3.27), previous service satisfaction (AOR=1.78, 95%CI: 1.26- 2.51), nearer to the health facility (AOR=3.09, 95%CI: 1.69-5.63), primary education and above (AOR=5.18, 95%CI: 2.99-8.96), knowledgeable mothers (AOR=2.30, 95%CI: 1.38-3.85) and waiting time (< 1-hour) (AOR=1.45, 95%CI: 1.02-2.08) were significantly associated factors. CONCLUSION: the prevalence of timely initiation was higher for transformed districts but it is below the WHO target. Higher wealth, previous service satisfaction, being nearer to the health facility, maternal education, being knowledgeable, and waiting time were significantly associated with timely initiation of the first ANC visit. Hence, the district´s transformation should be enhanced. Maternal knowledge, access, and quality of maternal health services should be enhanced.